title: ADad 6: the predictive factors for Anxiety Disorders among adolescents in a rural community population in India.
abstract: OBJECTIVE
  Development of Anxiety Disorders (AD) among adolescents is the interplay of risk and protective factors that have a biological and environmental basis. This study documents the predictive factors associated with the presence of AD among adolescents in India.
  
  
  METHODS
  The authors prospectively collected data for 500 adolescents in a community with independent, trained raters. Data on the dependent variable of AD and its subtypes was collected with Screen for Child Anxiety Related Emotional Disorders (SCARED), Socio-economic status with Modified Kuppuswamy Scale, depression with Beck Depression Inventory and the other independent variables with a specially designed proforma. The predictive factors for the presence of AD were analyzed with univariate and multivariate regression analyses appropriately, and a parsimonious predictive model was built.
  
  
  RESULTS
  Gender (adjusted OR = 1.96), and presence of Depressive Disorder (adjusted OR = 24.14) emerged as independent risk factors. Level of education came-out as a protective factor (adjusted OR = 0.66). Adolescent girls were at risk of developing Separation Anxiety Disorder (SeAD) (adjusted OR = 3.51) and Social Anxiety Disorder (SoAD) (adjusted OR = 1.69). Level of education had a protective influence on SeAD (adjusted OR = 0.39) and SoAD (adjusted OR = 0.59) among those doing high school. This protective effect increased if they were in higher-secondary school for SeAD (adjusted OR = 0.21) and SoAD (adjusted OR = 0.22). In the multivariate model age of the adolescent also gained significance and the 3-factor model had a good model fit. Panic Disorder and Generalized Anxiety Disorder were not related to any specific variable.
  
  
  CONCLUSIONS
  Identifying the factors associated with AD and the subtypes can be used to predict, prevent or treat these disorders in this population. Educating adolescent girls to higher-secondary school level seem to be an important step in this direction.
authors.affiliation: Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, South India, cdcmkc@gmail.com.
authors.forename: M K C
authors.initials: MK
authors.lastname: Nair
authors.forename: Paul Swamidhas Sudhakar
authors.initials: PS
authors.lastname: Russell
authors.forename: Vinod Shanmukham
authors.initials: VS
authors.lastname: Subramaniam
authors.forename: Suma
authors.initials: S
authors.lastname: Nazeema
authors.forename: Anupama Zeena
authors.initials: AZ
authors.lastname: Sequeira
authors.forename: Neethu
authors.initials: N
authors.lastname: Chembagam
authors.forename: Babu
authors.initials: B
authors.lastname: George
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D008960:Models, Psychological; D015233:Models, Statistical; D015999:Multivariate Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012423:Rural Health; D055815:Young Adult